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Journal of Clinical Microbiology, November 2007, p. 3568-3573, Vol. 45, No. 11
0095-1137/07/$08.00+0     doi:10.1128/JCM.00655-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Monitoring of Polyomavirus BK Virus Viruria and Viremia in Renal Allograft Recipients by Use of a Quantitative Real-Time PCR Assay: One-Year Prospective Study{triangledown}

Xiaoli L. Pang,1,4* Karen Doucette,2 Barbara LeBlanc,1 Sandra M. Cockfield,3 and Jutta K. Preiksaitis1,2

Provincial Laboratory for Public Health (Microbiology), University of Alberta Hospital,1 Division of Infectious Diseases,2 Division of Nephrology and Immunology,3 Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada4

Received 23 March 2007/ Returned for modification 19 August 2007/ Accepted 3 September 2007

We have developed a real-time quantitative PCR (rt-QPCR) assay to detect and kinetically monitor BK virus viruria and viremia in renal transplant recipients (RTRs). A total of 607 urine and 223 plasma samples were collected from 203 individuals including those with BK virus-associated nephropathy (BKVAN) (n = 8), those undergoing routine posttransplant surveillance (SV) (n = 155), those with nontransplant chronic kidney disease (NT-CKD) (n = 20), and healthy living kidney donors (LD) (n = 20). The rt-QPCR assay was found to be highly sensitive and specific, with a wide dynamic range (2.4 to 11 log10 copies/ml) and very good precision (coefficient of variation, ~5.9%). There was a significant difference in the prevalences of viruria and viremia between the BKVAN (100% and 100%) and SV (23% and 3.9%) groups (P < 0.001). No viruria or viremia was detected in LD or in NT-CKD patients. The median (range) peak levels of BK virus viruria and viremia, in log10 copies/ml, were 10.26 (9.04 to 10.83) and 4.83 (3.65 to 5.86) for the BKVAN group versus 0 (0 to 10.83) and 0 (0 to 5.65) for the SV group, respectively (P < 0.001). When the BK virus load in the urine was <7.0 log10 copies/ml, no BK virus viremia was detected. When the BK virus load in the urine reached 7.0, 8.0, 9.0, and ≥10.0 log10 copies/ml, the corresponding detection of BK virus viremia increased to 20, 33, 50, and 100%, respectively. We propose monitoring of BK virus viruria in RTRs, with plasma BK virus load testing reserved for those with viruria levels of ≥7.0 log10 copies/ml.

* Corresponding author. Mailing address: Provincial Laboratory for Public Health (Microbiology), University of Alberta Hospital, WMC 2B2.08, 8440 112 Street, Edmonton, Alberta, T6G 2J2, Canada. Phone: (780) 407-3483. Fax: (780) 407-8984. E-mail: x.pang{at}provlab.ab.ca

{triangledown} Published ahead of print on 12 September 2007.

Journal of Clinical Microbiology, November 2007, p. 3568-3573, Vol. 45, No. 11
0095-1137/07/$08.00+0     doi:10.1128/JCM.00655-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Costa, C., Bergallo, M., Astegiano, S., Terlizzi, M. E., Sidoti, F., Segoloni, G. P., Cavallo, R. (2008). Monitoring of BK virus replication in the first year following renal transplantation. Nephrol Dial Transplant 23: 3333-3336 [Abstract] [Full Text]  


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